Collaborative Stage

Collaborative Stage for TNM 7 - Revised 06/30/2011 [ Schema ]

Lung

CS Mets at DX

Note 1: Most pleural and pericardial effusions with lung cancer are due to tumor. In a few patients, however, multiple cytopathologic examinations of pleural and/or pericardial fluid are negative for tumor, and the fluid is nonbloody and is not an exudate. Where these elements and clinical judgment dictate that the effusion is not related to the tumor, the effusion should be excluded as a staging element and the tumor should be classified as M0.
Note 2: For contralateral (different lung) pleural effusion, use code 16 instead of code 40. For bilateral (same and different lung) pleural effusion, use code 17 instead of code 40.

Code	Description	TNM 7 Map	TNM 6 Map	SS77 Map	SS2000 Map
00	No distant metastasis	^	*	NONE	NONE
10	OBSOLETE DATA CONVERTED V0200 See code 30 Distant lymph node(s), including cervical nodes	ERROR	*	ERROR	ERROR
15	Malignant pleural effusion, ipsilateral or same lung	M1a	*	D	D
16	Malignant pleural effusion, contralateral or other lung	M1a	*	D	D
17	Malignant pleural effusion, ipsilateral and contralateral lungs (Bilateral pleural effusion)	M1a	*	D	D
18	Malignant pleural effusion, unknown if ipsilateral or contralateral lung	M1a	*	D	D
20	Malignant pericardial effusion	M1a	*	D	D
21	20 + (16 or 17) Malignant pericardial effusion plus contralateral or bilateral pleural effusion	M1a	*	D	D
23	Extension to: Contralateral lung Contralateral main stem bronchus Separate tumor nodule(s) in contralateral lung Pleural tumor foci or nodules on contralateral lung	M1a	*	D	D
24	Pleural tumor foci or nodules on the ipsilateral lung separate from direct invasion	M1a	*	D	D
25	23 + any of (15, 16, 17, 18, 20, 21, 24) Extension to contralateral lung plus pleural or pericardial effusion or separate pleural tumor foci	M1a	*	D	D
26	Stated as M1a with no other information on distant metastasis	M1a	*	D	D
30	Distant lymph node(s), including cervical nodes	M1b	*	D	D
32	30 + any of (15, 16, 17, 18, 20, 21) Distant lymph nodes plus pleural or pericardial effusion	M1b	*	D	D
33	30 + 24 Distant lymph nodes plus pleural tumor foci	M1b	*	D	D
35	OBSOLETE DATA RETAINED V0200 Separate tumor nodules reclassified in AJCC 7th Edition, coded in CS SSF 1 Separate tumor nodule(s) in different lobe, same lung	ERROR	*	L	D
36	30 + 23 Distant lymph nodes plus extension to contralateral lung	M1b	*	D	D
37	Extension to: Skeletal muscle Sternum Skin of chest	M1b	*	D	D
38	37 + 23 Extension in code 37 plus extension to contralateral lung	M1b	*	D	D
39	OBSOLETE DATA CONVERTED V0200 See code 23 Extension to: Contralateral lung Contralateral main stem bronchus Separate tumor nodule(s) in contralateral lung	ERROR	*	ERROR	ERROR
40	Abdominal organs Distant metastasis, except distant lymph node(s) and extension specified in codes 23 and 37, including: Separate lesion in chest wall or diaphragm Distant metastasis, NOS Carcinomatosis	M1b	*	D	D
41	40+ 23 Distant mets plus extension to contralateral lung	M1b	*	D	D
42	(37 or 40) + any of (15, 16, 17, 18, 20, 21) Distant metastasis plus pleural or pericardial effusion	M1b	*	D	D
43	(37 or 40) + 24 Distant metastasis plus pleural tumor foci	M1b	*	D	D
50	OBSOLETE DATA RETAINED V0200 Distant metastases + Distant node(s) (10) + any of (35 to 40)	ERROR	*	D	D
51	(37 or 40) + 30 Distant metastasis plus distant lymph node(s)	M1b	*	D	D
52	51 + any of (15, 16, 17, 18, 20, 21) Distant metastasis plus distant lymph nodes plus pleural or pericardial effusion	M1b	*	D	D
53	51 + 24 Distant metastases plus distant lymph nodes plus pleural tumor foci	M1b	*	D	D
70	Stated as M1b with no other information on distant metastasis	M1b	*	D	D
75	Stated as M1 [NOS] with no other information on distant metastasis	M1NOS	*	D	D
99	Unknown; distant metastasis not stated Distant metastasis cannot be assessed Not documented in patient record	^	*	U	U

^ For CS Mets at DX codes 00 and 99, the M category for AJCC 7 staging is assigned based on the value of CS Tumor Size as shown in the Size Mets at DX AJCC 7 Table for this schema.
* For all CS Met at Dx codes, the M category for AJCC 6 staging is assigned based on the values of CS Tumor Size, CS Extension, CS Mets at DX, and CS Site Specific Factor 1, as shown in the Size Extension Mets SSF1 AJCC 6 Tables for this schema.